经阴道实时三维超声造影评价宫外孕保守性治疗后输卵管通畅性的临床价值

Evaluation of the clinical value of transvaginal real-time three-dimensional ultrasound in the conservative treatment of ectopic pregnancy

目的探讨经阴道四维输卵管超声造影评价宫外孕经药物治疗以及保守性手术治疗后输卵管通畅性的临床价值。方法选取宫外孕患者120例,按治疗方式分为药物保守治疗(药物组)、开腹保守性手术治疗(开腹组)以及腹腔镜保守手术治疗(腹腔镜组),每组40例(40条输卵管),应用经阴道四维输卵管超声造影评价患者应用不同治疗方式治疗后输卵管的通畅性。结果腹腔镜组手术时间明显低于开腹组手术时间;腹腔镜组术中出血量明显低于开腹组手术时间。腹腔镜组术后排气时间、住院天数均低于对照组,腹腔镜组患者的月经恢复时间与对照组比较差异无统计学意义。治疗后,腹腔镜组、开腹组及药物组初始血β-HCG水平、血HCG下降至正常的天数比较差异有统计学意义。腹腔镜组输卵管通畅率为92.5%,优于开腹组输卵管通畅率70%、药物组输卵管通畅率65%。结论与药物治疗及开腹保守性手术治疗比较,腹腔镜保守性手术治疗后输卵管功能恢复更快。经阴道四维输卵管超声造影评价输卵管通畅性具有操作简单、无创等优势,值得推广。

Objective To evaluate the clinical value of transvaginal four-dimensional ultrasonography in the evaluation of ectopic pregnancy after drug treatment and conservative surgery for tubal patency.Methods 120 cases of patients with ectopic pregnancy were divided into conservative treatment(drug group),laparotomy conservative surgery(laparotomy group)and laparoscopic conservative surgery(laparoscopic group),each group of 40 cases,effect of transvaginal four-dimensional ultrasound fallopian tube imaging evaluation of ectopic pregnancy treatment of fallopian tube patency.Results The operative time of laparoscopic group was significantly lower than the laparotomy group operation time,the laparoscopic group of intraoperative bleeding was significantly lower than the laparotomy group operation time.The exhaust time and hospital stay in laparoscopic group were lower than that in control group,and there was no significant difference between the two groups.After treatment,there was a significant difference in the number of days between the laparoscopic group,the open group and the drug group,the initial blood beta-HCG level,and the number of HCG decreased to normal.Tubal patency rate of laparoscopic group was 92.5%,which was better than that of open group and 70%of tubal patency rate,and 65%.Conclusion Compared with conservative treatment and conservative surgery,laparoscopic conservative surgery in the treatment of tubal pregnancy tubal function recovery is faster.The evaluation of fallopian tube patency by transvaginal four-dimensional fallopian tube ultrasound has the advantages of simple operation and no invasive,which is worth popularizing.